Provider Demographics
NPI:1265421911
Name:ALTMAN, PAMELA A (NP)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:A
Last Name:ALTMAN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:258 HOOSICK ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-2427
Mailing Address - Country:US
Mailing Address - Phone:518-271-1331
Mailing Address - Fax:518-271-8712
Practice Address - Street 1:258 HOOSICK ST
Practice Address - Street 2:SUITE 106
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2427
Practice Address - Country:US
Practice Address - Phone:518-271-1331
Practice Address - Fax:518-271-8712
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2012-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY381452363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02406646Medicaid